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Safe patient handling in safer healthcare environment
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SAFE PATIENT HANDLING IN safer healthcare environment
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On the phone…
Chris BartonSEIU 1199NW
Dan DonahueProvidence St. Peter Hospital
Brenda SuiterWashington State Hospital Association
Lynn LaSalleMultiCare Health System
Barbara Silverstein Department of Labor & Industries
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CredoCredo
“Patients should not be harmed by the care that is intended to help them, nor should harm come to those who work in health care”
“Patients should not be harmed by the care that is intended to help them, nor should harm come to those who work in health care”
Crossing the Quality Chasm, 2001Crossing the Quality Chasm, 2001
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AgendaAgenda
Safe Patient Handling Law BackgroundSafe Patient Handling Law Background
Safe Patient Handling Website Safe Patient Handling Website
Law TimelinesLaw Timelines
Equipment requirements and fundingEquipment requirements and funding
QuestionsQuestions
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Safe Patient Handling LegislationSafe Patient Handling Legislation
Governor Gregoire signed Engrossed Governor Gregoire signed Engrossed Substitute House bill 1672 on March Substitute House bill 1672 on March 22, 200622, 2006
Bill became law on June 21, 2006Bill became law on June 21, 2006
Legislation makes safe patient Legislation makes safe patient handling part of how hospitals provide handling part of how hospitals provide care by adding this requirement to care by adding this requirement to DOH hospital licensing requirementsDOH hospital licensing requirements
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BackgroundBackground
The law was supported by: The law was supported by:
Service Employees International Union Service Employees International Union Local 1199NWLocal 1199NW
United Food & Commercial Workers’ United Food & Commercial Workers’ UnionUnion
Washington State Hospital AssociationWashington State Hospital Association
Washington State Nurses AssociationWashington State Nurses Association
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Why was the law enacted?Why was the law enacted?
To improve the safety of healthcare To improve the safety of healthcare employees and patientsemployees and patients
Provide funding to hospitals Provide funding to hospitals implementing safe patient handling implementing safe patient handling programsprograms
To improve nurse retentionTo improve nurse retention
To reduce costs to hospitalsTo reduce costs to hospitals
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Nurses lift an estimated 2 tons per shift
Do the math:Number of patients/dayNumber of lifts/patientAverage weight/patient
4 X 6 X 170 = 4,080lbs/day
Nurses lift an estimated 2 tons per shift
Do the math:Number of patients/dayNumber of lifts/patientAverage weight/patient
4 X 6 X 170 = 4,080lbs/day
We Know…We Know…
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We know…We know…
38% of nurses suffer work-related 38% of nurses suffer work-related back injuries requiring time away from back injuries requiring time away from workwork
12% of nurses consider leaving 12% of nurses consider leaving nursing due to low back pain at nursing due to low back pain at average age 39average age 39
Nurse aides have also experienced Nurse aides have also experienced significant injurysignificant injury
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“Zero-Lift” Program“Zero-Lift” Program
Lifting programs have been proven to Lifting programs have been proven to be effective. WHS’s Workers’ be effective. WHS’s Workers’ Compensation “Zero Lift Program” has Compensation “Zero Lift Program” has experienced remarkable success:experienced remarkable success: Patient Handling injuries had decreased by Patient Handling injuries had decreased by
43%43% Time loss frequency rates had decreased by Time loss frequency rates had decreased by
50%50%
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Safe Patient Handling Steering Committee
Safe Patient Handling Steering Committee
Collaboration developed to provide Collaboration developed to provide tools tools and modelsand models that will help hospitals that will help hospitals implement safe patient handling implement safe patient handling programs.programs. Healthcare UnionsHealthcare Unions Department of Labor & IndustriesDepartment of Labor & Industries Physical and Occupational TherapistsPhysical and Occupational Therapists Employee Health ManagersEmployee Health Managers Urban and Rural Hospital AdministratorsUrban and Rural Hospital Administrators Washington State Hospital AssociationWashington State Hospital Association Washington Hospital Services’ Workers’ Washington Hospital Services’ Workers’
Compensation ProgramCompensation ProgramBrought to you by
Law TimelinesLaw Timelines
February 1, 2007February 1, 2007 – establish safe – establish safe patient handling committeepatient handling committee
December 1, 2007December 1, 2007 – implement safe – implement safe patient handling programpatient handling program
January 30, 2010January 30, 2010 – acquire lifting – acquire lifting equipmentequipment
Enforced by the Department of HealthEnforced by the Department of Health
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Poll QuestionPoll Question
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Flow ChartFlow Chart
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February 1, 2007February 1, 2007
Establish a safe patient handling Establish a safe patient handling committee with at least half of the committee with at least half of the committee being direct care staffcommittee being direct care staff
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Establishing a CommitteeEstablishing a Committee
Recruit Participants (50% direct care Recruit Participants (50% direct care staff)staff)
Elect committee chair and co-chairElect committee chair and co-chair Develop meeting schedule and Develop meeting schedule and
protocolsprotocols
The primary responsibility of the committee The primary responsibility of the committee is to establish, implement and monitor the is to establish, implement and monitor the Safe Patient Handling Program.Safe Patient Handling Program.
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Labor ManagementLabor Management
The Steering Committee The Steering Committee recommends union recommends union involvement in committee involvement in committee development and decision development and decision makingmaking
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Poll QuestionPoll Question
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December 1, 2007December 1, 2007
Establish a safe Establish a safe patient handling programpatient handling program
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Safe Patient Handling Program
Safe Patient Handling Program
Safe patient handling program shall include and Safe patient handling program shall include and hospitals must:hospitals must:
1.1. Implement a safe patient handling policyImplement a safe patient handling policy2.2. Conduct a safe patient handling hazard Conduct a safe patient handling hazard
assessmentassessment3.3. Develop a process to identify the appropriate use Develop a process to identify the appropriate use
of the safe patient handling policy based on of the safe patient handling policy based on patient needs and availability of equipmentpatient needs and availability of equipment
4.4. Conduct an annual performance evaluationConduct an annual performance evaluation5.5. Consider the feasibility of incorporating Consider the feasibility of incorporating
equipment when constructing or remodeling a equipment when constructing or remodeling a hospitalhospital
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Establishing a Safe Patient Handling Program
Establishing a Safe Patient Handling Program
1.1. Implement a safe patient handling policy Implement a safe patient handling policy for all shifts and units of the hospitalfor all shifts and units of the hospital
It is recommended your safe patient handling It is recommended your safe patient handling committee draft a policy togethercommittee draft a policy together
2.2. Conduct patient handling hazard Conduct patient handling hazard assessment. Include variables such as assessment. Include variables such as patient handling tasks, types of nursing patient handling tasks, types of nursing units, patient populations, and the units, patient populations, and the physical environmentphysical environment
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Establishing a Safe Patient Handling Program
Establishing a Safe Patient Handling Program
3.3. Facilitate the development of Facilitate the development of standards for assessing each patient standards for assessing each patient and their activitiesand their activities
A.A. Get input for department staffGet input for department staff
B.B. Include how to document and share Include how to document and share information across shifts and information across shifts and departmentsdepartments
C.C. Consider using algorithmsConsider using algorithms
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Establishing a Safe Patient Handling Program
Establishing a Safe Patient Handling Program
4.4. Conduct an annual performance Conduct an annual performance evaluation of the program to evaluation of the program to determine its effectiveness-report determine its effectiveness-report results to your safe patient handling results to your safe patient handling committeecommittee
5.5. When developing architectural plans, When developing architectural plans, consider the feasibility of consider the feasibility of incorporating patient handling incorporating patient handling equipment into the design equipment into the design
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What Makes a Successful Program?What Makes a Successful Program?
Analyze what works already in your Analyze what works already in your hospital:hospital:
Existing practicesExisting practices
Attitudes about changeAttitudes about change
Administration’s supportAdministration’s support
Organizational cultureOrganizational culture
Barriers to changeBarriers to change
Current patient flowCurrent patient flowBrought to you by
Know Current PracticesKnow Current Practices
Department practices and Department practices and techniques already used for techniques already used for handling their patient populationhandling their patient population
Who is influential in each Who is influential in each department department the leaders of co-workers the leaders of co-workers
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Educate Your HospitalEducate Your Hospital
Committee members to their role on Committee members to their role on the team, empower them to do their the team, empower them to do their workwork
Management - for staffing, so team Management - for staffing, so team members can attend meetings and do members can attend meetings and do their worktheir work
Keep the committee informed of their Keep the committee informed of their accomplishments so they feel accomplishments so they feel successfulsuccessful
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Campaign – Build MomentumCampaign – Build Momentum
Use every modality possible to share Use every modality possible to share what is being planned and implemented:what is being planned and implemented: Recruit an Administration sponsor who will Recruit an Administration sponsor who will
speak directly to the care giversspeak directly to the care givers Design in accountability of managers, Design in accountability of managers,
supervisors, charge nurses, house supervisors, charge nurses, house supervisors and direct care givers; to know supervisors and direct care givers; to know when the team meetings occur, who the when the team meetings occur, who the members are, department’s need for members are, department’s need for equipment, what systems and techniques equipment, what systems and techniques will change, processes for acquiring what will change, processes for acquiring what they need, etc. they need, etc.
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Inform Your Patients, Families, and VisitorsInform Your Patients, Families, and Visitors
Advertise in brochures, newsletters, Advertise in brochures, newsletters, hospital bulletin boardshospital bulletin boards
Create expectationsCreate expectations
Make the work of the committee Make the work of the committee public, positive and rewardingpublic, positive and rewarding
Please visit website to view a sample marketing Please visit website to view a sample marketing materialsmaterials
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Individual Patient AssessmentIndividual Patient Assessment
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Risk & Needs Assessment Risk & Needs Assessment
Measures to eliminate or reduce Measures to eliminate or reduce patient handling risks must be patient handling risks must be identifiedidentified Conduct an analysis of injuriesConduct an analysis of injuries Identify and prioritize patient handling Identify and prioritize patient handling
risksrisks Assess patient mobility needsAssess patient mobility needs Conduct an inventory of patient Conduct an inventory of patient
handling equipmenthandling equipment Identify environmental and system Identify environmental and system
barriersbarriersBrought to you by
Learn From Your MistakesLearn From Your Mistakes
Conduct annual performance Conduct annual performance evaluations of the:evaluations of the:
System’s policy System’s policy
Committee’s workCommittee’s work
Program effect on injuries & falls Program effect on injuries & falls
Equipment UseEquipment Use
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Annual Performance EvaluationAnnual Performance Evaluation
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Change Can Be HardChange Can Be Hard
Have activities with rewards for Have activities with rewards for individual care givers and individual care givers and departments:departments:
Informal brown-bag lunchesInformal brown-bag lunches
Departments can compete against Departments can compete against each othereach other RodeosRodeos
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A Successful ProgramA Successful Program
Adheres to the requirements of the Adheres to the requirements of the lawlaw
Meets all deadlinesMeets all deadlines
Uses the available toolsUses the available tools
Involves your safe patient handling Involves your safe patient handling team in decision makingteam in decision making
Shares experiences, ask questionsShares experiences, ask questions
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Washington Regulatory Requirements1Washington Regulatory Requirements1
When developing architectural plans When developing architectural plans for constructing or remodeling a for constructing or remodeling a hospital or unit, the hospital must hospital or unit, the hospital must consider the feasibility of consider the feasibility of incorporating patient handling incorporating patient handling equipment or design needed to equipment or design needed to incorporate equipment later.incorporate equipment later.
11RCW 70.41.390 RCW 70.41.390
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Before The Blue PrintsBefore The Blue Prints
Get all levels of staff Get all levels of staff involvedinvolved
Think about all possible Think about all possible scenariosscenarios
Place real users in a Place real users in a mock up of the design mock up of the design concept and simulate concept and simulate simulationsimulation
Full scale simulation Full scale simulation with props or3-D with props or3-D computer simulationscomputer simulationsBrought to you by
Working Space Transfer to Bed(Add 12” all around the bed for bariatric patient)
Working Space Transfer to Bed(Add 12” all around the bed for bariatric patient)
Transfer bed /wheel Transfer bed /wheel chair or bed to chair or bed to stretcher: 1500 mm stretcher: 1500 mm 5’5’
Transfer with floor lift Transfer with floor lift or bed/geriatric chair or bed/geriatric chair 1800 mm 6’ (ceiling 1800 mm 6’ (ceiling lift saves 12”)lift saves 12”)
Space for care giver Space for care giver and rest chair 100 and rest chair 100 mm 39”mm 39”
Door room width Door room width 1220 mm (48”) for 1220 mm (48”) for bariatric patientbariatric patient
*Adapted from Jocelyn Villeneuve, Design for Safe Patient Handling
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Single Bed/Bath Room LayoutSingle Bed/Bath Room Layout
Total Space ~180 sq ftTotal Space ~180 sq ft
Side nearest the door 6’ Side nearest the door 6’ for a transfer involving for a transfer involving floor device add 12” for floor device add 12” for bariatricbariatric
Window side 47”Window side 47”
Foot of Bed 47”Foot of Bed 47”
Bed faces the door Bed faces the door privacy maintained privacy maintained with curtain, better with curtain, better observation and transfer observation and transfer (working) space(working) space
Door width 1220 mm Door width 1220 mm (48”) for bariatric patient(48”) for bariatric patient
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Bathroom SpaceBathroom SpaceMake sure equipment, Make sure equipment, staff and patient can fit in staff and patient can fit in space.space.
• 36” door36” door
• 24” minimum clearance on 24” minimum clearance on each side of toileteach side of toilet
• Retractable bars attached Retractable bars attached to wall for client transfers to wall for client transfers assisted by 1-2 care giversassisted by 1-2 care givers
• Wheel Chair rotation 5’ Wheel Chair rotation 5’ diameterdiameter
• Toilet weight tolerance Toilet weight tolerance needs to be 600+ lbsneeds to be 600+ lbs
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January 1, 2008January 1, 2008
A hospital shall develop procedures for A hospital shall develop procedures for hospital employees to refuse to perform or hospital employees to refuse to perform or be involved in patient handling or movement be involved in patient handling or movement that the hospital employee believes in good that the hospital employee believes in good faith will expose a patient or a hospital faith will expose a patient or a hospital employee to an unacceptable risk of injury. employee to an unacceptable risk of injury.
A hospital employee who in good faith follows A hospital employee who in good faith follows the procedure developed by the hospital in the procedure developed by the hospital in accordance with this subsection shall not be accordance with this subsection shall not be the subject of disciplinary action by the the subject of disciplinary action by the hospital for the refusal to perform or be hospital for the refusal to perform or be involved in the patient handling or involved in the patient handling or movement.movement.Brought to you by
Employee RightsEmployee Rights
Hospitals MUST develop procedures for Hospitals MUST develop procedures for employees to refuse to perform or be employees to refuse to perform or be involved in patient handling or involved in patient handling or movement task that the employee movement task that the employee believes “in good faith” will expose a believes “in good faith” will expose a patient or employee to an unacceptable patient or employee to an unacceptable risk of injuryrisk of injury
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January 30, 2010January 30, 2010
Each hospital must complete, at a Each hospital must complete, at a minimum, acquisition of their choice of:minimum, acquisition of their choice of: One readily available lift per acute care unit One readily available lift per acute care unit
on the same floor unless the safe patient on the same floor unless the safe patient handling committee determines a lift is handling committee determines a lift is unnecessary in the unit; unnecessary in the unit;
One lift for every ten acute care available One lift for every ten acute care available inpatient beds; orinpatient beds; or
Equipment for use by lift teams Equipment for use by lift teams
Hospitals must train staff on policies, Hospitals must train staff on policies, equipment, and devices at least annuallyequipment, and devices at least annually
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January 30, 2010January 30, 2010
Acquire equipment using your hazard Acquire equipment using your hazard assessment, injury data and with the assessment, injury data and with the input of the hospital’s safe patient input of the hospital’s safe patient handling committeehandling committee
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Acquire EquipmentAcquire Equipment
Step 1: Step 1: Establish a safe patient handling Establish a safe patient handling committee (50% direct care staff) committee (50% direct care staff)
Step 2: Step 2: Train the safe patient handling Train the safe patient handling committee committee
Step 3: Step 3: Write your Safe Patient Handling Write your Safe Patient Handling Policy Policy
Step 4: Step 4: Assess the risks and needs for Assess the risks and needs for each unit in your hospital each unit in your hospital
Step 5: Plan for the purchase of Step 5: Plan for the purchase of equipmentequipment
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Our “Challenge” Is: Getting the Equipment & Changing Practice…
Our “Challenge” Is: Getting the Equipment & Changing Practice…
Getting from manual Getting from manual handling…handling…
To safe patient To safe patient handling…handling…
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Where is High Injury Risk Exposure?Where is High Injury Risk Exposure?
Inpatient Rooms*Inpatient Rooms*(+ OR, PACU, Rehab)(+ OR, PACU, Rehab)
RepositioningRepositioning Move up, roll, cleanMove up, roll, clean
TransferringTransferring Bathroom/CommodeBathroom/Commode WalkingWalking Bed to GurneyBed to Gurney Bed to ChairBed to Chair
Example of continuous track from patient room to bathroom
*Biomechanical Evidence… William Marras, PhD, CPE Brought to you by
Where to put track…Where to put track… Committee Decision – Need/Data DrivenCommittee Decision – Need/Data Driven
CCU-Tele-Neuro-Med/Renal-RehabCCU-Tele-Neuro-Med/Renal-Rehab
Remodel DrivenRemodel Driven Or combo data/remodel, needs to be cleared Or combo data/remodel, needs to be cleared
w/committeew/committee
““Track” As Many Rooms As Possible*Track” As Many Rooms As Possible* Fixed Lifts – view rooms, plus as follows… Fixed Lifts – view rooms, plus as follows…
Isolation RoomsIsolation Rooms CCUCCU Known heavy low mobile patient care Known heavy low mobile patient care
areasareas Portables (475 lb capacity) 1 per 5 roomsPortables (475 lb capacity) 1 per 5 rooms
Use until you have budget for fixed liftsUse until you have budget for fixed lifts
*Tampa General Model Brought to you by
Patient Transfer Devices Floor lifts/Bariatric Room Set-upFloor lifts/Bariatric Room Set-up
From floor, chair, bed, also sit to stand & walkingFrom floor, chair, bed, also sit to stand & walking
Slider Transfer SheetsSlider Transfer Sheets Lateral and horizontal transferLateral and horizontal transfer
Ceiling LiftsCeiling Lifts Repositioning, floor to bed, bed to chairRepositioning, floor to bed, bed to chair
BedsBeds Chair posit., flexi-foot, TrendelenburgChair posit., flexi-foot, Trendelenburg
Transport devicesTransport devices Zoom stretcher, bariatric stretcher, “Ergo-tug”Zoom stretcher, bariatric stretcher, “Ergo-tug”
This is a cut out of our transfer device locatorThis is a cut out of our transfer device locator
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Ceiling Lifts
Portable lift on gantry Portable lift on gantry (xy) configuration(xy) configuration Repositioning is easyRepositioning is easy
Full body Full body repositioning slingrepositioning sling
Seated universal Seated universal slingsling
Pam working Pam working with training with training dummy and dummy and ceiling lift.ceiling lift.
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December 30, 2010December 30, 2010
A hospital may take a credit for the A hospital may take a credit for the cost of purchasing mechanical cost of purchasing mechanical
lifting devices and other equipment lifting devices and other equipment that are primarily used to minimize that are primarily used to minimize
patient handling by health care patient handling by health care providers, consistent with a safe providers, consistent with a safe
patient handling program patient handling program developed and implemented by the developed and implemented by the
hospitalhospitalBrought to you by
B&O Tax CreditB&O Tax Credit
All hospitals qualify for the B&O Tax All hospitals qualify for the B&O Tax CreditCredit
Hospitals can receive up to $1000 per Hospitals can receive up to $1000 per acute care available inpatient bed acute care available inpatient bed
The number of acute care available The number of acute care available inpatient beds in each hospital is inpatient beds in each hospital is based on the year-end financial based on the year-end financial reports submitted to the Department reports submitted to the Department of Healthof Health
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Poll QuestionPoll Question
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The Patient Handling BibleThe Patient Handling Bible
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In SummaryIn Summary
Use hazard assessment, injury data Use hazard assessment, injury data and committee to make equipment and committee to make equipment acquisitions acquisitions
Equipment: key pointsEquipment: key points
Engage your facilities staff & give Engage your facilities staff & give ergonomic input for construction ergonomic input for construction remodel designremodel design
Think BIG and spend lots!Think BIG and spend lots!
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Thank youThank youService Employees Service Employees International Union International Union Local 1199NWLocal 1199NW
Washington State Washington State Nurses AssociationNurses Association
Regional HospitalRegional Hospital
Regional Hospital for Regional Hospital for Respiratory and Respiratory and Complex CareComplex Care
Valley Medical CenterValley Medical Center MulticareMulticare
St. Mary Medical St. Mary Medical CenterCenter
Valley General Valley General HospitalHospital
United Food & United Food & Commercial Workers Commercial Workers Union Local 21Union Local 21
Harrison Medical Harrison Medical CenterCenter
Kittitas Valley Kittitas Valley HospitalHospital
United Food & United Food & Commercial Workers Commercial Workers Union Local 141Union Local 141
Providence St. Peter Providence St. Peter HospitalHospital
Empire Health Empire Health ServicesServices
Department of Labor Department of Labor & Industries& Industries
Washington State Washington State Hospital AssociationHospital Association
Swedish Medical Swedish Medical CenterCenter
WHS Workers’ WHS Workers’ Compensation Compensation ProgramProgram
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Thank youThank you
Chris BartonSEIU 1199NW
Dan DonahueProvidence St. Peter Hospital
Brenda SuiterWashington State Hospital Association
Lynn LaSalleMultiCare Health System
Barbara Silverstein Department of Labor & Industries
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QuestionsQuestions
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Thank you for participating!
Please fill out the evaluation.Please fill out the evaluation.
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This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India. We need lots of funds manpower etc. to make this vision a reality please contact us. Join us as a member for a noble cause.
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India. We need lots of funds manpower etc. to make this vision a reality please contact us. Join us as a member for a noble cause.
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